Clinical data in early intervention.

Research into early intervention for Alzheimer's disease (AD) and dementia has involved cohort data from large epidemiological studies and data from specifically designed intervention trials. Cohort data indicate that use of nootropics and Ginkgo biloba extract may be associated with a reduced incidence of dementia and death. Data from large trials have often been inconclusive due to issues with poor medication adherence. However, such trials do indicate potential benefits with Gingko biloba extract in terms of reduced incidence of dementia of the AD type, vascular dementia and mixed pathology, reduced progression in terms of the clinical dementia rating and improvements in attention and memory. Furthermore, Gingko biloba extract EGb 761® is a useful option for long-term intervention on the basis of decades of previous experience and an excellent safety record. However, benefits can be expected only with sufficient medication adherence and treatment duration, so clear evidence of a disease-modifying benefit of this extract is needed from adequately designed trials using modern methods to ensure high levels of adherence.